Communication series

Conversations with people facing death with Professor Bridge

Dear fellow health professional,

I commend to you the videos “Conversations with People Facing Death”.
During 30 years practising as a Palliative Medicine specialist in several countries I discovered that a healing relationship requires high level skills in communication. Communication relies on the intuitive appreciation of subtle cues. However, the education of health professionals has a general “left brain” focus.

Patients facing imminent death are rarely interested in their serum potassium. They want kindness, truth, compassion, and the reassurance of accompaniment rather than abandonment.

There are many excellent teaching videos addressing communication skills. This series is unique in several ways: the participants are real, not actors, and the text is unscripted.

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The Conversations were filmed in Royal Perth Hospital in 2010, with the patients sitting in their own beds or chairs. There was no agenda, no instructions or rehearsals, no floodlights or special equipment. The voices of nurses tending a patient in the adjacent bed can be clearly heard in one of the recordings.

To add to the realism of the Conversations, I did not know any details of the patients. At my request, the Palliative Care team at RPH selected patients they thought might be suitable and willing to chat with me on camera. I was given only the patient’s name, principal diagnosis, and their location in the hospital. My purpose was to demonstrate that a conversation could plunge to deep levels quickly, depending on the ability of the interviewer in “generous listening” as taught by Carl Rogers.
I thought my request was unusual, almost outrageous, and I expected to have difficulty finding people who would be willing to participate. To my surprise, every patient eagerly agreed to my request. I believe this reflects the observation that, as their health declines, patients experience a sense of diminished value. They were pleased to be able to contribute to medical education for the benefit of other patients.

So, these are totally real, raw, authentic conversations.

The original DVD was produced by staff of the Medical Illustrations Department of RPH. The production was funded by a grant from the medical school of WA. The grant application described the project as, “Interviews with Dying Patients”. As the recordings progressed, I realised that the word “interviews” was too formal; the label “patient” was demeaning; and describing them as “dying” was misleading: they were “living” life intensely.

The Conversations grapple with universal questions such as the nature of suffering and the ultimate meaning of living and dying. These recordings are confronting and challenging. Some viewers could find them disturbing. I recommend viewing only one at a time, ideally with a colleague, so that insights can be discussed and shared.

I want to express my deepest thanks to Peter Stream, Basim Alattar, Nevin Richards, Lesley Symons, Bruce Thompson, and Joseph Crolla, who bravely disclosed their innermost secrets.

Doug Bridge
Remember that in a healing relationship, both participants benefit. As Balfour Mount puts it, “healing begets healing begets healing”. May you experience personal healing as you promote healing in others.

Why this course?

During 30 years practising as a Palliative Medicine specialist in several countries Prof Bridge discovered that a healing relationship requires high level skills in communication. Patients facing imminent death are rarely interested in their serum potassium. They want kindness, truth, compassion, and the reassurance of accompaniment rather than abandonment.

There are many excellent teaching videos addressing communication skills. This series is unique in several ways: the participants are real, not actors, and the text is unscripted. The Conversations were filmed in Royal Perth Hospital in 2010, with the patients sitting in their own beds or chairs. There was no agenda, no instructions or rehearsals, no floodlights or special equipment. The voices of nurses tending a patient in the adjacent bed can be clearly heard in one of the recordings.

These videos are featured in some of the PaSCE education and are now available for Clinical staff and students to watch and use in their own development.